Armed with LASIK info, patients ask questions
Be prepared to address complications, outcomes
For the first time, a single resource is available with a clear, understandable explanation of who is a good candidate for laser in-situ keratomileusis (LASIK), an explanation of the preoperative evaluation, tools for patients to test their expectations to make sure they are reasonable, and questions for patients to ask surgeons and staff at the evaluation.
That news comes from Roger F. Steinert, MD, associate clinical professor at Harvard Medical School and a physician in private practice at Ophthalmic Consultants of Boston. Steinert co-wrote the guidelines for the Fairfax, VA-based American Society of Cataract and Refractive Surgery.
LASIK has long been under scrutiny from the Washington, DC-based Federal Trade Commis-sion (FTC) and former patients who say they were lured by false advertising and didn’t fully understand the side effects. Recent studies indicate that 1% to 5% of patients suffer side effects, which may include double vision, glare, halos or star bursts of light, dry eyes, and even some loss of vision, according to one media report.1 In that story, nationally distributed by the Associated Press, one patient advised others to visit LASIK centers to watch the procedure, obtain second opinions, and call former patients.
The San Francisco-based American Academy of Ophthalmology recently concluded LASIK is best for moderate, not severe, vision problems.2 (For more information, see Journal Review, Same-Day Surgery, March 2002, p. 41.) The guidelines suggest that potential patients should ask their surgeons a list of questions, including, "What type of testing will you do in order to determine whether I’m a candidate for LASIK?"
Steinert says dedicated refractive surgeons already should be providing all of these assessments. "The reasons for this section are [twofold]: to educate the patient about the seriousness and complexity of good treatment planning; to alert the patient if the site is not doing necessary testing," he says.
The other questions patients are encouraged to ask their surgeons are:
- Has my glasses or contact lens prescription been consistent for at least two years?
- Does my nearsightedness, farsightedness, or astigmatism fall within the accepted levels established for surgery by the Food and Drug Administration?
- Are my corneas thick enough to perform LASIK surgery?
- Do I have cataracts, glaucoma, or other corneal diseases?
- Are my corneas scarred?
- Do I have any diseases that would affect the outcome of the surgery or my ability to heal properly?
- Are there any other reasons why I may not be a candidate for LASIK surgery?
- Am I at risk for complications?
- What can I expect during the procedure?
- What outcome can I expect from the surgery?
(Editor’s note: For more on the FTC, informed consent, and LASIK, see Same-Day Surgery, January 2001, p. 1. Subscribers can access this story at the archives at www.same-daysurgery.com. Your user name is your subscriber number from the mailing label. Your password is sds plus subscriber number.)
References
1. Associated Press. Is laser eye surgery right for you? June 4, 2002. Accessed at http://wire.ap.org.
2. Sugar A, Rapuano CJ, Culbertson WW, et al. Laser in situ keratomileusis for myopia and astigmatism: Safety and efficacy — A report by the American Academy of Ophthalmology. Ophthalmology 2002; 109:175-187.
Sources and resources
For more information on the laser in-situ keratomileusis (LASIK) guidelines, contact: Roger F. Steinert, MD, Ophthalmic Consultants of Boston, 50 Staniford St., Boston, MA 02114. Telephone: (617) 367-4800. E-mail: [email protected].
To obtain a free copy of the guidelines, go to www.ascrs.org. Under "new and noteworthy," click on "Eye Surgery Education Council" and then "LASIK Screening Guidelines." Or for a free single copy, write:
• LASIK Guidelines, American Society of Cataract and Refractive Surgery, 4000 Legato Road, Suite 850, Fairfax, VA, 22033.
• Surgical Eyes, a Tampa, FL-based group of injured patients, created a web site that illustrates what it’s like to see through various LASIK-caused side effects. The web site is www.surgicaleyes.org. It includes forums, news, and information on how to file complaints. It averages 60,000 visitors per month.
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